How to: Combat Cancer Related Fatigue (CRF)

Combating Cancer Related Fatigue (CRF) during and after cancer treatment by Megan Oster, Lead Cancer Care Physiotherapist at Six Physio. 

Following our weekend @Battle Cancer what better time to share Megan’s knowledge…
Exercise been shown to be more effective than pharmaceuticals and psychological treatment (see 5)

CRF is a complex, but common symptom, affecting 70-100% of all cancer patients. Fatigue is different from the tiredness we all feel at the end of the day. It is described as “persistent, debilitating and overwhelming feeling of exhaustion which can’t be explained by other physiological means or relieved by sleep or rest”.

Basically, it is not proportional to recent physical activity and interferes with day to day activities! Unfortunately, it can persist for years post cancer treatment.

1) Link in with a trained health professional to identify causes of fatigue
There are many causes of CRF and it is important to link in with a trained health professional, such as an oncological physiotherapist to help determine the cause. This allows targeted treatment, allowing a quicker recovery.

2) Track your activity with an ‘activity diary’
Tracking your day to day routine and subsequent energy levels is a nice way to determine good and bad trends within each day. IE. are you doing too much in a day and this is causing a roll on effect later in the day or the next day?

3) Practice good sleep patterns
Follow a bed-time routine and try to go to bed at the same time each night. Limit screen time in the evening and practice tasks that help you to relax.

4) Stick to the 4 P’s of energy conservation:

  • Plan: Plan out each day to ensure you don’t exhaust your energy levels with upcoming tasks (your activity diary will help determine this level). Plan to alternate between heavier and lighter tasks throughout the week.
  • Pace: Don’t ‘boom or bust’ a day, especially if you are having a ‘good day’. This may have a roll on effect in the next day or 2. Pace your day and slowly increase your levels. Ensure you rest before you feel tired.
  • Prioritise: What is important to you within each day? What must you complete today? What can you complete at a later date?
  • Posture: When sitting or standing, adopt a nice upright position. This conserves energy and allows more oxygen to move around the body.

5) Build up your physical activity levels

  • Exercise is the number one treatment for CRF and has been shown to be more effective that pharmaceuticals and psychological treatment. Physiotherapists play an important role in prescribing tailored physical activity programs.
  • Begin to look at this from point of diagnosis.
  • Previously active: continue as much as possible, within the limitations of your treatment plan.
  • Previously sedentary: commence slowly and progress steadily. Link in with a cancer care physiotherapist who can supervise this with you.

Don’t put up with fatigue: whilst common during and after treatment, seek advice and treatment from a specialist cancer care physiotherapist.

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